Individual
JACLYN K SIMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
21 CENTER ST, MIDDLETOWN, NY 10940-5704
(845) 343-7675
Mailing address
21 CENTER ST, MIDDLETOWN, NY 10940-5704
(845) 343-7675
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26640
NY
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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